Search

BackgroundModeling suggests that climate change mitigation actions can have substantial human health benefits that accrue quickly and locally. Documenting the benefits can help drive more ambitious and health-protective climate change mitigation actions; however, documenting the adverse health effects can help to avoid them. Estimating the health effects of mitigation (HEM) actions can help policy makers prioritize investments based not only on mitigation potential but also on expected health benefits. To date, however, the wide range of incompatible approaches taken to developing and reporting HEM estimates has limited their comparability and usefulness to policymakers.ObjectiveThe objective of this effort was to generate guidance for modeling studies on scoping, estimating, and reporting population health effects from climate change mitigation actions.MethodsAn expert panel of HEM researchers was recruited to participate in developing guidance for conducting HEM studies. The primary literature and a synthesis of HEM studies were provided to the panel. Panel members then participated in a modified Delphi exercise to identify areas of consensus regarding HEM estimation. Finally, the panel met to review and discuss consensus findings, resolve remaining differences, and generate guidance regarding conducting HEM studies.ResultsThe panel generated a checklist of recommendations regarding stakeholder engagement: HEM modeling, including model structure, scope and scale, demographics, time horizons, counterfactuals, health response functions, and metrics; parameterization and reporting; approaches to uncertainty and sensitivity analysis; accounting for policy uptake; and discounting.DiscussionThis checklist provides guidance for conducting and reporting HEM estimates to make them more comparable and useful for policymakers. Harmonization of HEM estimates has the potential to lead to advances in and improved synthesis of policy-relevant research that can inform evidence-based decision making and practice. https://doi.org/10.1289/EHP6745.

Background: The health effects of heat are well documented; however, limited information is available regarding the health risks of hot nights. Hot nights have become more common, increasing at a faster rate than hot days, making it urgent to understand the characteristics of the hot night risk. Objectives: We estimated the effects of hot nights on the cause- and location-specific mortality in a nationwide assessment over 43 y (1973-2015) using a unified analytical framework in the 47 prefectures of Japan. Methods: Hot nights were defined as days with a) minimum temperature [greater than or equal to]25[degrees]C (H[N.sub.25]) and b) minimum temperature [greater than or equal to]95th percentile (H[N.sub.95th]) for the prefecture. We conducted a time-series analysis using a two-stage approach during the hot night occurrence season (April-November). For each prefecture, we estimated associations between hot nights and mortality controlling for potential confounders including daily mean temperature. We then used a random-effects meta-analytic model to estimate the pooled cumulative association. Results: Overall, 24,721,226 deaths were included in this study. Nationally, all-cause mortality increased by 9%- 10% [H[N.sub.25] relative risk (RR) = 1.09, 95% confidence interval (CI): 1.08, 1.10; H[N.sub.95th] RR = 1.10, 95% CI: 1.09, 1.11] during hot nights in comparison with non hot nights. All 11 cause-specific mortalities were strongly associated with hot nights, and the corresponding associations appeared to be acute and lasted a few weeks, depending on the cause of death. The strength of the association between hot nights and mortality varied among prefectures. We found a higher mortality risk from hot nights in early summer in comparison with the late summer in all regions. Conclusions: Our findings support the evidence of mortality impacts from hot nights in excess of that explicable by daily mean temperature and have implications useful for establishing public health policy and research efforts estimating the health effects of climate change. https://doi.org/10.1289/EHP11444, Introduction Due to progressing global warming, the frequency and intensity of extreme heat events have increased, and hot days and nights are expected to be more frequent in the near [...]

The purpose of this study was to investigate five Japanese graduate (master's level) students' experiences in online courses in international development and peace through sport that used English as the medium of instruction. The study was situated in the framework of andragogy theory and used a descriptive-qualitative design using an in-depth, semistructured interview approach using online oral and written interviews. Three emergent themes were established. These recurrent themes were (a) learning online specialized content using English as a second language, (b) students' struggles in group projects through online education, and (c) students' opinions about the improvement of online education. To better support Japanese graduate students' online learning, this study encourages academic departments, administrators, and faculty to better design appropriate courses and online activities. This will contribute to a greater appreciation for the richness of sports development and peace and to increasing the availability of meaningful academic and social experiences for graduate students at Japanese universities. [ABSTRACT FROM AUTHOR]

Background: Although substantial evidence suggests that high and low temperatures are adversely associated with nonaccidental mortality, few studies have focused on exploring the risks of temperature on external causes of death. Objectives: We investigated the short-term associations between temperature and external causes of death and four specific categories (suicide, transport, falls, and drowning) in 47 prefectures of Japan from 1979 to 2015. Methods: We conducted a two-stage meta-regression analysis. First, we performed time-stratified case-crossover analyses with a distributed lag nonlinear model to examine the association between temperature and mortality due to external causes for each prefecture. We then used a multivariate meta-regression model to combine the association estimates across all prefectures in Japan. In addition, we performed stratified analyses for the associations by sex and age. Results: A total of 2,416,707 external causes of death were included in the study. We found a J-shaped exposure-response curve for all external causes of death, in which the risks increased for mild cold temperatures [20th percentile; relative risk (RR) = 1.09 (95% confidence interval [CI]: 1.05,1.12)] and extreme heat [99th percentile; RR= 1.24 (95% CI: 1.20, 1.29)] compared with those for minimum mortality temperature (MMT). However, the shapes of the exposure-response curves varied according to four subcategories. The risks of suicide and transport monotonically increased as temperature increased, with RRs of 1.35 (95% CI: 1.26, 1.45) and 1.60 (95% CI: 1.35, 1.90), respectively, for heat, whereas J- and U-shaped curves were observed for falls and drowning, with RRs of 1.14 (95% CI: 1.03,1.26) and 1.95 (95% CI: 1.70,2.23) forheatand 1.13 (95% CI: 1.02,1.26) and 2.33 (95% CI: 1.89,2.88) for cold, respectively, compared with those for cause-specific MMTs. The sex- and age-specific associations varied considerably depending on the specific causes. Discussion: Both low and high temperatures may be important drivers of increased risk of external causes of death. We suggest that preventive measures against external causes of death should be considered in adaptation policies. https://doi.org/10.1289/EHP9943, Introduction External causes of death are death caused by acute exposure to physical agents such as mechanical energy, heat, electricity, chemicals, and ionizing radiation and the broad categories include transport, [...]

Air pollution has been a severe issue in China. Exposure to PM2.5 has adverse health effects and causes economic losses. This study investigated the economic impact of exposure to PM2.5 pollution using monthly city-level data covering 88.5 million urban employees in 2016 and 2017. This study mainly focused on three expenditure indicators to measure the economic impact considering lower respiratory infections (LRIs), coronary heart disease (CHD), and stroke. The results show that a 10 µg/m3 increase in PM2.5 would cause total monthly expenses of LRIs, CHD, and stroke to increase by 0.226%, 0.237%, and 0.374%, respectively. We also found that LRI, CHD, and stroke hospital admissions increased significantly by 10%, 8.42%, and 5.64%, respectively. Furthermore, the total hospital stays of LRIs, CHDs, and strokes increased by 2.49%, 2. 51%, and 1.64%, respectively. Our findings also suggest heterogeneous impacts of PM2.5 exposures by sex and across regions, but no statistical evidence shows significant differences between the older and younger adult subgroups. Our results provide several policy implications for reducing unequal public health expenditures in overpolluted countries. [ABSTRACT FROM AUTHOR]

Climate change, air pollution, and the rapidly aging population are important public health challenges. An understanding of air pollution impacts is imperative for preventing air-pollution-related deaths and illnesses, particularly in vulnerable subgroups such as the increasing population of older adults. To assess the effects of short-term air-pollution exposure on the elderly, we conducted a time-series analysis (1996–2015) of the associations between particulate matter with an aerodynamic diameter of <10 μm (PM10) and deaths among elderly residents of Seoul, South Korea, which has a rapidly aging population. We also investigated the synergistic effects of temperature and the lag structures of the effects by sex, cause of death, and season. A 10 μg/m3 rise in the 4-day moving average concentration of PM10 was associated with 0.31% (95% confidence interval (CI): 0.18% to 0.44%), 0.32% (95% CI: 0.09% to 0.55%), and 0.22% (95% CI: –0.23% to 0.66%) increases in non-accidental, cardiovascular, and respiratory mortalities, respectively. We found a significant and strong synergistic effect of PM10 concentration and ambient temperature on mortality in elderly people. PM10 posed an increased risk of non-accidental or cardiovascular mortality with increasing temperature, whereas the associated risk of respiratory death was highest on very cold days. The shape and length of the lag structure varied with the cause of death, sex, and season. Results indicate that elderly people exposed to PM10 are at increased risk of premature death. In the near future, these risks are likely to increase in step with the temperature rise associated with climate change and the continued population aging. Stronger emission controls will be needed to minimize the increased health risks associated with air pollution, especially in regions with high populations of elderly individuals. [ABSTRACT FROM AUTHOR]